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Nettle Allergy: a Review and Clinical Perspective

  • Allergic Rhinitis (J Maspero, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Abstract

Purpose of review

Stinging nettle (Urtica dioica) is a common cause of contact urticaria worldwide; however, its clinical relevance in allergic rhinitis and aeroallergen immunotherapy has not been well established. This presents a clinical conundrum to the physician and can potentially impact the effectiveness of treatment of allergic rhinitis in nettle sensitized patients. The objectives of this article are to review the available literature regarding the geographic distribution of nettle, allergen(s) involved, cross-reactivity, role in allergic rhinitis, immunotherapy efficacy, and provide a clinical perspective on the evaluation and treatment of nettle sensitized patients.

Recent findings

Stinging nettle (Urtica dioica) is a bi-annual pollinator with worldwide distribution and wide use in homeopathy. Limited data suggest that nettle pollen allergens may be considered clinically relevant and that nettle pollen allergy may be underestimated. More recent allergomic analysis of nettle pollen has revealed protein allergens including an osmotin and a pectin esterase which may implicate cross-reactivity with other pollens and foods. One study describes in vivo nettle immunotherapy.

Summary

Overall, there is a paucity of medical literature evaluating the role of nettle in allergic rhinitis with even fewer studies assessing the clinical efficacy of nettle immunotherapy. Cross-reactivity patterns with other pollens and foods remains to be fully elucidated. Given the immense medical and economic impact of allergic rhinitis and the worldwide distribution of nettle, prospective randomized controlled trials are needed to evaluate the possible contribution of nettle allergy and efficacy of nettle immunotherapy.

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Acknowledgements

Susan Kosisky, Chief Microbiologist (for ELMS data via T-con 31Jan2018) at The United States Army Centralized Allergen Extract Laboratory.

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Authors and Affiliations

  1. Department of Allergy/Immunizations, Wilford Hall Ambulatory Surgical Center, Wilford Hall Loop Building 4554, Lackland AFB, TX, 78236-9908, USA

    Rebecca Schapira DO & Karla Adams MD

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  1. Rebecca Schapira DO
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  2. Karla Adams MD
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Correspondence to Rebecca Schapira DO.

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The authors declare that they have no competing interests.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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The opinions or assertions herein are the private views of the authors and are not to be construed as reflecting the views of the Department of the Air Force or the Department of Defense.

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This article is part of the Topical Collection on Allergic Rhinitis

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Schapira, R., Adams, K. Nettle Allergy: a Review and Clinical Perspective. Curr Treat Options Allergy 5, 310–318 (2018). https://doi.org/10.1007/s40521-018-0178-0

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  • DOI: https://doi.org/10.1007/s40521-018-0178-0

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